Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.61 / $74.05 / $127.91	Facility		$32.61	$74.05	$127.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.10 / $32.61 / $77.31	Professional		$25.10	$32.61	$77.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.65 / $37.65 / $38.47	Professional		$37.65	$37.65	$38.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $43.95 / $126.07 / $268.63	Facility		$43.95	$126.07	$268.63
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $38.39 / $47.19 / $398.48	Professional		$38.39	$47.19	$398.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.77 / $34.77 / $34.77	Facility		$34.77	$34.77	$34.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.38 / $25.38 / $35.61	Professional		$25.38	$25.38	$35.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $31.39 / $53.40 / $137.53	Facility		$31.39	$53.40	$137.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $54.00 / $105.92	Professional		$31.42	$54.00	$105.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.63 / $38.47 / $42.32	Professional		$34.63	$38.47	$42.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.85 / $49.02 / $50.19	Facility		$39.85	$49.02	$50.19
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $45.17 / $50.19 / $50.19	Professional		$45.17	$50.19	$50.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.95 / $56.37 / $98.04	Facility		$43.95	$56.37	$98.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.67 / $41.67 / $88.55	Professional		$41.67	$41.67	$88.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $47.77 / $49.02 / $49.02	Facility		$47.77	$49.02	$49.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $39.88 / $42.66 / $55.21	Professional		$39.88	$42.66	$55.21
United Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $37.57 / $47.77	Professional		$25.04	$37.57	$47.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.22 / $31.22 / $42.66	Professional		$31.22	$31.22	$42.66